Figure 1. . Magnetic resonance and computed tomography of neck tumor at presentation and after treatment.

(A) Coronal MRI showing two large obvious left-sided neck masses (arrows). Superior mass is a 7 × 4.8 × 4.6 cm suboccipital tumor surrounding the vertebral artery on the left and pushing on the dural sac at C1–C3. The inferior mass (7 × 4.8 × 5.4 cm) infiltrates the sternocleidomastoid muscle with displacement of paraspinal muscles. A radiological differential diagnosis was not rendered. (B) Follow-up CT scan after chemotherapy demonstrating ill-defined 3.5 × 2.2 cm left suboccipital mass (between arrows). (C & D) MRI of the spine 14 months after initial presentation with metastases present in the intradural region of T4 (arrow in [C]) and multiple metastases in the lumbosacral cord (arrows in [D]).